What can cause hypoglycaemic symptoms like extreme lightheadedness and dizziness when blood glucose is fine

[mamakitty]

What would be the cause of hypoglycaemic symptoms while the blood glucose is either okay or even sometimes on the higher end of okay. Same with the blood pressure.
I regularly get symptoms that mimic hypoglycaemia such as feeling very lightheaded or extremely faint along with slight nausea and also just shutting down and feeling very sleepy, but the blood glucose is NOT low.
The blood pressure is also NOT low.
It can sometimes improve with resting or sleeping, and sometimes by eating. However, sometimes I get these episodes after eating, while at other times I get them when I haven’t had enough calories. They are occasionally accompanied by headaches, and occasionally by vertigo and nausea.

I just want to know general causes so I can look them up. It could be the ear balance issue, but I’m not sure. These episodes really shut me down for an hour or two. It’s been happening for many years but have become more frequent in the last couple of years.

 

[redsun]

What would be the cause of hypoglycaemic symptoms while the blood glucose is either okay or even sometimes on the higher end of okay. Same with the blood pressure.
I regularly get symptoms that mimic hypoglycaemia such as feeling very lightheaded or extremely faint along with slight nausea and also just shutting down and feeling very sleepy, but the blood glucose is NOT low.
The blood pressure is also NOT low.
It can sometimes improve with resting or sleeping, and sometimes by eating. However, sometimes I get these episodes after eating, while at other times I get them when I haven’t had enough calories. They are occasionally accompanied by headaches, and occasionally by vertigo and nausea.

I just want to know general causes so I can look them up. It could be the ear balance issue, but I’m not sure. These episodes really shut me down for an hour or two. It’s been happening for many years but have become more frequent in the last couple of years.

This is likely hyponatremia from lack of sodium. Low sodium diets are to blame or things like caffeine can make you lose more sodium. Some people don't retain sodium as well either so they just need more generally.

 

[mamakitty]

Not enough sodium. Low sodium diets or things like caffeine can make you lose more sodium. Some people don't retain sodium as well either so they just need more generally.

I don’t follow a low sodium diet despite my doctor’s “orders”. I salt my food to taste and follow some cravings. I don’t drink coffee these days, just weak tea with milk and sugar. However, you mention losing sodium which may be true when I don’t eat enough I pee a LOT. But the dizzy spells are not connected to the times I’m peeing a lot.

 

[yerrag]

If HbA1c is your basis for saying your blood sugar is low, that isn't really valid even though the corrupt medical mafia says so.

How can it be when Ray Peat disses its as a blood sugar marker, and his criticism is that HbA1c is not so much influenced by blood sugar, as much as it is influenced by free fatty acids, of the unsaturated kind?

Besides, HbA1c is also a lagging indicator of whatever it is measuring. It is the average of the past 3 months of whatever is being measured. If you were taking temperature, would you submit to a marker that measures the average of the past 3 months of your temperature? How useful would that be?

But since that is the dictate of the medical mafia, we mostly kowtow to them and use something that's pretty useless because they say so, and because that is the test their health insurance accomplice will reimburse.

 

[mamakitty]

If HbA1c is your basis for saying your blood sugar is low, that isn't really valid even though the corrupt medical mafia says so.

How can it be when Ray Peat disses its as a blood sugar marker, and his criticism is that HbA1c is not so much influenced by blood sugar, as much as it is influenced by free fatty acids, of the unsaturated kind?

Besides, HbA1c is also a lagging indicator of whatever it is measuring. It is the average of the past 3 months of whatever is being measured. If you were taking temperature, would you submit to a marker that measures the average of the past 3 months of your temperature? How useful would that be?

But since that is the dictate of the medical mafia, we mostly kowtow to them and use something that's pretty useless because they say so, and because that is the test their health insurance accomplice will reimburse.

Actually, my blood sugar is NOT low when I have these episodes, which is what makes this so confusing for me.
I’m not basing this on hba1c, I use a glucometer to sometimes test fasting and postprandial blood glucose.

 

[redsun]

I don’t follow a low sodium diet despite my doctor’s “orders”. I salt my food to taste and follow some cravings. I don’t drink coffee these days, just weak tea with milk and sugar. However, you mention losing sodium which may be true when I don’t eat enough I pee a LOT. But the dizzy spells are not connected to the times I’m peeing a lot.

You should try and consume some salt next time this happens. If your blood sodium level is low it will improve within minutes.

Excessive urination can deplete sodium and make hyponatremia more likely. Its not always immediate however as your body tries its best to keep the sodium it needs but it can definitely compound the problem and push you towards the direction of hyponatremia.

When you don't eat, your remaining glycogen is depleting so the water it holds also it goes. Normally when you are regularly fed your glycogen doesnt drop so much between meals but as soon as you skip a meal this changes.

 

[mamakitty]

You should try and consume some salt next time this happens. If your blood sodium level is low it will improve within minutes.

Excessive urination can deplete sodium and make hyponatremia more likely. Its not always immediate however as your body tries its best to keep the sodium it needs but it can definitely compound the problem and push you towards the direction of hyponatremia.

When you don't eat, your remaining glycogen is depleting so the water it holds also it goes. Normally when you are regularly fed your glycogen doesnt drop so much between meals but as soon as you skip a meal this changes.

Do you recommend consuming salt even if the blood pressure is normal or slightly elevated at that moment?

 

[redsun]

Do you recommend consuming salt even if the blood pressure is normal or slightly elevated at that moment?

Yes.

 

[mamakitty]

Yes.

Okay, I’ll try it next time. Thank you!

 

[yerrag]

Actually, my blood sugar is NOT low when I have these episodes, which is what makes this so confusing for me.
I’m not basing this on hba1c, I use a glucometer to sometimes test fasting and postprandial blood glucose.

If it's about headaches, it may be about having low oxygen, or low sugar. But of these two causes, I'm more inclined to look into low oxygen.

Low oxygen could be caused by low tissue oxygenation, and that is caused by low CO2 in your blood, which would make it hard for hemoglobin to release oxygen to the brain tissues. And that can give you a headache, or even worse, give you brain fog.

Can you measure your breath rate? I use an Android app called Respi-Rate.

An ideal breath rate is 14 breaths per minute. When acidic, it gets to be higher. When alkaline, it becomes lower.

There is some play allowed by our body, so being 12 bpm or 18 bpm still allows me to get away with enough tissue oxygenation, but too low, say below 10, and too high, above 20, may cause poor tissue oxygenation. When it's too low, there is too little carbon dioxide for certain, and that is why the body is not breathing as fast, because it wants to hold on to the little CO2 it has. When it's too high, it may be that there's too much lactic acid, and when this happens, there is too little CO2 as CO2 has been exhaled.

If you can install the app and play around with it, and get yourself to breathe normally (I find this to be difficult as being aware I'm measuring my breath rate makes me breathe too slow or too fast) and then to measure your breath rate.

I haven't dealt with having a low breath rate, so I don't know how to deal with it based on experience.

But I once measured 22, and I thought maybe my metabolism had turned glycolytic, and that I was producing too much lactic acid (I was sick that time from a bacterial infection, which could affect my metabolism). I took 2 x1000mg thiamine that day, and that made my breath rate go down, and that increased CO2 in my blood. I don't do this often, and don't recommend taking that much thiamine daily, but one time is fine to correct an imbalance. Thiamine will convert lactic acid to glucose, and thus lower the lactic acid in my system, and in my blood. My headache disappeared shortly.

 

[yerrag]

As far as becoming hungry even when your blood sugar is high goes, I would think it odd as hunger is usually associated with blood sugar being low. But if you are also feeling sleepy and tired, as well as being hungry, then it means that your tissues are not absorbing sugar quickly enough (and that's why your blood sugar is high), and that your metabolism is not optimal, with not the entirety of the sugar and oxygen used to produce energy being done so in an efficient manner, such that you're producing all or most of your energy through mitochondrial respiration. With this, you produce the most ATP and you produce a lot of CO2 as well.

Sometimes, if the energy produced from sugar metabolism isn't uninterrupted, then the liver won't be processing T4 into T3 without interruption. When the production of T3 is interrupted, it destroys the flow and supply of energy needed for optimal sugar metabolism. This would cause you to feel hungry and sleepy. I once tried to take some Tyronene drops for T3 when I felt this way, and this helped restore the flow of energy.

 

[youngsinatra]

I have dizziness and vertigo for 6 months now.
What helped me was taking high dose B1, getting off vitamin A and getting my vitamin D up, which needs testing in my opinion to find the individual requirements. I begin to believe that we need more vitamin D than once thought. I think 1000 IU only raise blood levels by 5-10ng/ml long-term. I‘ve seen lots of vitamin D blood tests from friends and relatives.
And interestingly I‘ve seen big improvements even when vitamin D was increased from 30-40 ng/ml (which is already sufficient/good) to 60-80 ng/ml. (optimal)
I worked with my mother and we got her 25OHD to 80 ng/ml and she is in remission of her rheuma since and does not need to take the daily cortison and hardcore immunosuppressants since then. Also fixed her blood pressure, insomnia and extreme daytime fatigue.

Nevertheless, back to you - do you know your vitamin D level? Do you supplement? And if you do, how much do you take?

 

[mamakitty]

If it's about headaches, it may be about having low oxygen, or low sugar. But of these two causes, I'm more inclined to look into low oxygen.

Low oxygen could be caused by low tissue oxygenation, and that is caused by low CO2 in your blood, which would make it hard for hemoglobin to release oxygen to the brain tissues. And that can give you a headache, or even worse, give you brain fog.

Can you measure your breath rate? I use an Android app called Respi-Rate.

An ideal breath rate is 14 breaths per minute. When acidic, it gets to be higher. When alkaline, it becomes lower.

There is some play allowed by our body, so being 12 bpm or 18 bpm still allows me to get away with enough tissue oxygenation, but too low, say below 10, and too high, above 20, may cause poor tissue oxygenation. When it's too low, there is too little carbon dioxide for certain, and that is why the body is not breathing as fast, because it wants to hold on to the little CO2 it has. When it's too high, it may be that there's too much lactic acid, and when this happens, there is too little CO2 as CO2 has been exhaled.

If you can install the app and play around with it, and get yourself to breathe normally (I find this to be difficult as being aware I'm measuring my breath rate makes me breathe too slow or too fast) and then to measure your breath rate.

I haven't dealt with having a low breath rate, so I don't know how to deal with it based on experience.

But I once measured 22, and I thought maybe my metabolism had turned glycolytic, and that I was producing too much lactic acid (I was sick that time from a bacterial infection, which could affect my metabolism). I took 2 x1000mg thiamine that day, and that made my breath rate go down, and that increased CO2 in my blood. I don't do this often, and don't recommend taking that much thiamine daily, but one time is fine to correct an imbalance. Thiamine will convert lactic acid to glucose, and thus lower the lactic acid in my system, and in my blood. My headache disappeared shortly.

Hi yerrag, thanks for the detailed response. I think it might be low oxygen because blood glucose registers as normal or occasionally high end of normal. Rarely it’s on the low end of normal, but never low.

Thanks for mentioning that app, I’m going to look for it for iphone.

Regarding thiamine, it actually gives me really bad hypoglycaemic symptoms. I have to take the minimal dose and even that right before a bigger meal, or else I get all the symptoms I described in my original post.

 

[mamakitty]

As far as becoming hungry even when your blood sugar is high goes, I would think it odd as hunger is usually associated with blood sugar being low. But if you are also feeling sleepy and tired, as well as being hungry, then it means that your tissues are not absorbing sugar quickly enough (and that's why your blood sugar is high), and that your metabolism is not optimal, with not the entirety of the sugar and oxygen used to produce energy being done so in an efficient manner, such that you're producing all or most of your energy through mitochondrial respiration. With this, you produce the most ATP and you produce a lot of CO2 as well.

Sometimes, if the energy produced from sugar metabolism isn't uninterrupted, then the liver won't be processing T4 into T3 without interruption. When the production of T3 is interrupted, it destroys the flow and supply of energy needed for optimal sugar metabolism. This would cause you to feel hungry and sleepy. I once tried to take some Tyronene drops for T3 when I felt this way, and this helped restore the flow of energy.

Yes, it’s very odd to feel hungry and like dying but the blood sugar is normal. I think you are definitely correct my metabolism is terrible. I’m also very very heat sensitive, I get the same shutting down symptoms and feel like I’m suffocating when I feel hot. The summers are particularly difficult for me if the ac is down. It was thousand times worse during pregnancy. Actually I cannot stand even a little bit of heat anyway, which is hilarious because I’m also always cold due to hypothyroidism. So it’s basically a comedy show at home with me constantly changing the thermostat. I mean it would be funny if I weren’t suffering lol.

Anyway, clearly my metabolism is broken and nothing really helps. I’m so scared of going down the pharma route my doctor is forcing me for very high ldl

Also, I’m unable to procure t3, my doctor has outright refused to prescribe it because “she doesn’t work with it”.
I take t4 the smallest dose every morning. I have experimented with not taking the morning dose, and it seems to have no bearing on my dizzy hypoglycaemic dying symptoms. When I first began to take t4 I started getting a lot of chest and left arm pain. I have a history of this pain since I was a child when I get stressed out about something. Anyway, when I started t4, the pain was different as in it was very long last almost omnipresent. I suspected t4 and google confirmed it could give heart issues. The doctor did not consider this, sent me for ecg and echo. They turned out to be okay. Actually the ecg showed borderline but it seems that was because my breasts were very large due to so much weight gain. I have had ecg done twice before too. One of the time it showed I had a lot of gas which was giving me chest pains. That was when I was relatively thin. The other time, the reading was difficult to get because I had gained a lot of weight by then and bigger breasts were a problem, but they eventually got it done and the results were fine. I still get these pains, they had gone away for about two thirds of the year but they are semi regular again.

Anyway, I have so many problems it’s not right trying to jam them in one comment post. For now, I’m trying to figure out and get rid of the hypoglycaemia mimicking symptoms I get. It was a daily occurrence for most of a year, then it went away a year ago, but came back in summer. And now it’s a bit more frequent again.
I will be trying salt like redsun suggests above. I am trying to optimise my thyroid at the same time but without t3 as we stand.

Edit to add a couple things:
Regarding blood sugar, I initially thought I might have reactive hypoglycaemia but my glucometer says otherwise. However, if I eat ice cream the symptoms go away almost always. I’m now thinking what if it’s hypoglycaemia but not reflecting in the blood right away? For example, I had an episode literally an hour ago today. I checked the blood glucose and it was 5.7 mmol. I had eaten a Chicago style hotdog (with bun) and tea with milk and sugar not even 30-?40 minutes earlier and I was feeling hungry and dizzy and nauseous . Anyway I felt so bad, I gave in and had a few spoons of ice cream. After which I’m feeling okay now.

This is pretty much the same with my heat reaction. When I get bad symptoms from heat (even a little bit heat sometimes) the only thing that makes me feel better is ice cream. Not just any thing sweet, it has got to be sweet and cold! Which is literally the same reaction I get after motion sickness. When I have been in a car on a hot day or any day with windows closed for a long time, I start suffocating and feeling very dizzy and nauseous. Same thing after flying, upon landing and on the ride home I always get this sickness. Then I have to have cold mango juice (that I generally hate otherwise) with salty lays chips.

 

[mamakitty]

I have dizziness and vertigo for 6 months now.
What helped me was taking high dose B1, getting off vitamin A and getting my vitamin D up, which needs testing in my opinion to find the individual requirements. I begin to believe that we need more vitamin D than once thought. I think 1000 IU only raise blood levels by 5-10ng/ml long-term. I‘ve seen lots of vitamin D blood tests from friends and relatives.
And interestingly I‘ve seen big improvements even when vitamin D was increased from 30-40 ng/ml (which is already sufficient/good) to 60-80 ng/ml. (optimal)
I worked with my mother and we got her 25OHD to 80 ng/ml and she is in remission of her rheuma since and does not need to take the daily cortison and hardcore immunosuppressants since then. Also fixed her blood pressure, insomnia and extreme daytime fatigue.

Nevertheless, back to you - do you know your vitamin D level? Do you supplement? And if you do, how much do you take?

Thanks for responding sinatra. Unfortunately thiamine makes me feel so very hypoglycaemic. I only take 100mg and if I don’t eat enough right after that, I feel terrible. In fact, complex B does the same to me.
My vitamin d was I think 20 or 30 early 2020. I cannot remember but it was in the “good” range. I semi regularly take 2 to 3 thousand iu of D. I was taking 5,000iu for a while especially in my pregnancy. But since the whole blackburn debate I’m confused about it.
I never took vitamin A, i eat liver occasionally. I sometimes take magnesium bisglycinate too. I do a lot of supplements actually, but I’m thinking of streamlining the pills lol. I am taking b complex, k2, d semi regularly, e occasionally, coq10 very occasionally, magnesium semi regularly, aspirin occasionally. I was taking niacin to decrease my very high ldl but I stopped. Might start niacin again plus policosanol for ldl, and ovasitol for ovulation regulation. Oh also, I’m about to receive black seeds so might chew them semi regularly.

 

[Tim Lundeen]

I wonder if your diet contains relatively high levels of deoxysugars? They cannot be converted to energy, and could cause the symptoms you describe. Deoxy sugar - Wikipedia

You could try eliminating all possible sources, see what happens. Probably would take 3-4 days to clear any residue so you can tell.

DDT poisoning might also cause these symptoms, and possibly related compounds. Is it possible you have some exposure?

 

[mamakitty]

I wonder if your diet contains relatively high levels of deoxysugars? They cannot be converted to energy, and could cause the symptoms you describe. Deoxy sugar - Wikipedia

You could try eliminating all possible sources, see what happens. Probably would take 3-4 days to clear any residue so you can tell.

DDT poisoning might also cause these symptoms, and possibly related compounds. Is it possible you have some exposure?

I don’t know what foods can contain deoxy sugars. Could you please give me examples?
I also don’t know what ddt poisoning is and how I can be exposed to it. Could you please tell me what are the risk factors?

 

[Tim Lundeen]

I don't know what you're eating, but whole foods have low deoxysugars. Processed foods like sugar and molasses, can have high levels (not common but can happen).

I don't know where you're living. DDT is mostly banned today, but is still used in some places, still used in some mosquito netting. It's an organocholorine. It was replaced by organophospates, such as malathion. I don't know if organophosphates can affect blood glucose like DDT. You might get try getting rid of any ant/insect poisons in your environment. Do they spray your building for termites? That might affect you.

I don't know if the herbicide glyphosate could cause these symptoms, but possible. Are you using roundup, etc? Good to eliminate all these herbicides/pesticides.

 

[mamakitty]

I don't know what you're eating, but whole foods have low deoxysugars. Processed foods like sugar and molasses, can have high levels (not common but can happen).

I don't know where you're living. DDT is mostly banned today, but is still used in some places, still used in some mosquito netting. It's an organocholorine. It was replaced by organophospates, such as malathion. I don't know if organophosphates can affect blood glucose like DDT. You might get try getting rid of any ant/insect poisons in your environment. Do they spray your building for termites? That might affect you.

I don't know if the herbicide glyphosate could cause these symptoms, but possible. Are you using roundup, etc? Good to eliminate all these herbicides/pesticides.

Oh thanks for that. I generally eat whole foods, but sometimes cheat with gross junk food, however I almost never get those shutting down symptoms after eating junk food! I’m also not fully onboard with the sugar stuff yet, so I don’t really eat that much sugar and I have never added molasses yet. I do eat a couple or so spoons of raw honey every day. And the only thing that actually does make me feel better when I’m feeling so dizzy and nauseous and weak is literally ice cream.

Regarding ddt, I gather it’s some pesticide. I have never lived anywhere that would have had this sprayed. My building might have done termite spray but we never got any notification so I think it’s highly unlikely they did while I have been here, and it’s a new building.

 

[Tim Lundeen]

So new buildings can be offgassing various chemicals. Do you feel ok when you travel or are away? Maybe try a short vacation...

They might just routinely spray for termites without notification, often done at the ground-level exterior.